Tackling irritable bowel syndrome: Ways to ease the pain of IBS

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It affects around one in five people at some point in their lives and can often cause misery.

Irritable bowel ­syndrome is one of the most common conditions that any GP sees. It affects around one in five people at some point in their lives and can often cause misery. There’s no single known cause, so treatment is directed at relieving symptoms. There’s no medical therapy that can alter its course. It’s most common in younger people and more women suffer than men.

It causes great discomfort, with uncomfortable bloating and alternating constipation and diarrhoea. Doctors label it as “functional” along with fibromyalgia and ME, which may co-exist with IBS, as no organic cause has been discovered. A recent report in the British Medical Journal classified IBS into categories according to stool type: IBS-D (diarrhoea); IBS-C (constipation); IBS-M (mixed). Women are likely to be IBS-C, men IBS-D.

No single cause has been discovered but many mechanisms have been proposed: high levels of stress, family history and abnormal transit times in the small and large bowel. The BMJ suggests a close brain-bowel connection, with bowel hypersensitivity and abnormal pain processing in the brain because sufferers seem to have lower pain thresholds than people without IBS. However, there are many treatment options worth trying, though pain relief could be a bit hit and miss.

The latest high-powered Cochrane Review questioned the benefits of fibre. But, on the other hand, a particular form of soluble fibre, ispaghula, improved symptoms significantly. It’s worth a try. The problem for doctors is that over and over again placebos – dummy pills – have been shown to work in cases of IBS. One analysis of 73 reliable studies showed a placebo improvement rate of almost 40%. This makes it hard to say if a treatment is working or if all that’s required is a belief that it will. The FODMAP diet, which excludes many fermenting foods, does work for many, as do antispasmodic drugs – even peppermint oil. An antibiotic, rifaximin, has brought relief and probiotics, particularly bifidobacteria, have beneficial effects, probably due to their anti-inflammatory activity.

Source: Mirror UK

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